Coronavirus Risk Management and Clinical

Coronavirus Risk Management and Clinical

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RISK MANAGEMENT AND CLINICAL FREQUENTLY ASKED QUESTIONS
March 22, 2020

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Patient Safety & Risk Management Department: (720) 858-6396
24/7 Risk Mgmt. Hotline—For Urgent After Hours Calls: (720) 858-6270 or (866) 274-7511

We are receiving a high call volume and want to assure you that if you leave a message, we will respond in a timely manner. If you have been working with a specific staff member you should continue to contact them on their direct line or via email.

What steps should I take regarding staff exposure?
COPIC encourages you to read and follow the guidance being provided by the CDC:
https://www.cdc.gov/coronavirus/2019-ncov/hcp/ 

Should elective surgeries continue at ambulatory surgery centers during the COVID-19 pandemic?
• The ASCA has released its guidelines at the following site: https://www.ascassociation.org/asca/resourcecenter/latestnewsresourcecenter/covid-19
• CDC guidelines: 
https://www.cdc.gov/coronavirus/2019-ncov/healthcare-facilities/index.html
• CDC Public Health Reminder
     o Health care facilities and clinicians should prioritize urgent and emergency visits and procedures now and for the coming several weeks. The following actions can preserve staff, personal protective equipment, and patient care supplies; ensure staff and patient safety; and expand available hospital capacity during the COVID-19 pandemic:
           Delay all elective ambulatory provider visits
           Reschedule elective and non-urgent admissions
           Delay inpatient and outpatient elective surgical and procedural cases
           Postpone routine dental and eyecare visits

Does a clinic have to accept and examine established patients if the patient contacts the clinic and reports symptoms consistent with COVID-19? 
• CDC Guidance: https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-guidance-management-patients.html
     o Practical guidance for practices that includes visuals: https://www.cdc.gov/coronavirus/2019-ncov/downloads/Clinic.pdf
     o Practical guidance for facilities that includes visuals: https://www.cdc.gov/coronavirus/2019-ncov/infection-control/control-recommendations.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fhcp%2Finfection-control.html
• In general, practitioners do need to conduct an appropriate encounter with their established patients; however, “appropriate” is what is current per the CDC and CDPHE. Mild to moderate symptomatic patients should NOT be seen in the office unless one can ensure adequate personal protective equipment for all persons (and that is not considered an inappropriate use of a scarce resource). They should be screened for the severity of their disease and their risk of co-morbid conditions via remote means—phone or telemedicine—and, if consistent with mild to moderate COVID-19, practitioners can advise patients to self-quarantine for 14 days and on the various symptomatic measures and precautions to take for worsening disease. If the patient is high-risk or has a severe disease, then the practitioner can instruct the patient to be evaluated at an ED.
• There are not enough testing capabilities at this time, and they are reserving testing for high-risk patients, hospitalized patients, and health care workers who have been exposed.
• Patient abandonment rules and regulations still apply. Reference your state’s licensing board for additional guidelines. 

Telehealth—Is there any risk regarding coding correctly for telehealth given they are all rolling this out quickly?
• Centers for Medicare & Medicaid Services Medicare Telemedicine Health Care Provider Fact Sheet: 
https://www.cms.gov/newsroom/fact-sheets/medicare-telemedicine-health-care-provider-fact-sheet 
• Email and Text: We recommend referencing the HIPAA guidelines regarding communications: https://www.hhs.gov/hipaa/for-professionals/special-topics/emergency-preparedness/index.html

Telehealth—Staff working from home—what security measures do I need for billing and other communications?
• American Academy of Family Physicians COVID-19 resources: 
https://www.aafp.org/patient-care/emergency/2019-coronavirus.html
• ECRI COVID-19 Resource Center:
https://www.ecri.org/coronavirus-covid-19-outbreak-preparedness-center?utm_campaign=HRC%20Alerts&utm_source=hs_email&utm_medium=email&utm_content=84920073&_hsenc=p2ANqtz-84WIl8zfPuB08jhk_MTvzVpDcRigBKJSYw4PTtIc4GJEIT0YHeiGeAYP4KGcN9IK59xyCOtL49XEBf63brue9gaPER3w&_hsmi=84920073

CDC guidance and information for employers, practices, and facilities: 
• This is a general link for employers: 
https://www.cdc.gov/coronavirus/2019-ncov/community/guidance-business-response.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fspecific-groups%2Fguidance-business-response.html
• This is a general link for health care facilities:
https://www.cdc.gov/coronavirus/2019-ncov/healthcare-facilities/index.html
• This is a specific link for practices that includes printable resources you can download:
https://www.cdc.gov/coronavirus/2019-ncov/healthcare-facilities/practice-preparedness.html